Magnifying endoscopy offers limited guidance for treating non-granular laterally spreading tumors (lst-ng), crucial for surgical decisions.

• Pseudodepressed lesions show significantly higher rates of high-grade dysplasia (78.1% vs. 31.2%) and T1 carcinoma (34.4% vs. 2%).
• All T1b carcinomas were found in pseudodepressed lesions, emphasizing the need for en bloc resection.

Surgeons should prioritize technical feasibility for en bloc resection over reliance on magnifying endoscopic findings.